Head injury severity

It is surprisingly difficult to predict the degree of brain injury from the size of the blow to the head. Some patients after a severe blow to the head sustain little injury to the brain. Others will suffer severe brain injury associated with prolonged unconsciousness, merely as a result of hitting their head on the ground by falling over from the standing position. There is anecdotal evidence that significant brain injury can result from a head injury with no, or momentary, loss of consciousness (see postconcussion.syndrome below). The presence of a skull fracture says little about the severity of the brain injury incurred.

There are several clinical indicators of head injury severity ( BoxJ). Of these the duration of retrograde amnesia is probably the least valuable: it correlates very poorly with head injury severity. The duration of the retrograde amnesia tends to shrink as the patient recovers.

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